Individual
KIM-TIEN QUOC PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
2709 HEMLOCK ST, BREMERTON, WA 98310-2623
(360) 782-6000
(360) 782-6099
Mailing address
2709 HEMLOCK ST, BREMERTON, WA 98310-2623
(360) 782-6000
(360) 782-6099
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP61073230
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2165705
—
WA
Enumeration date
06/27/2020
Last updated
01/20/2021
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